FAQ: German Health Insurance

Answer's to frequently asked questions about health insurance in Germany

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Public or Private insurance?

Reasons for and against public insurance are numerous. However, it is often times misunderstood how significant the differences between public and private insurance are in terms of coverage.  Understanding the differences is the best starting point to making a decision.

-> Benefits overview: Public vs. private insurance in Germany

Who has access to private health insurance?

    Employees

    Not everyone in Germany has the opportunity to enroll for private health insurance. Employees are able to insure themselves privately if their annual income is above the compulsory insurance limit, which is redefined each year by the federal government and based on the annual income development. In 2019 it is 60.750 Euro (“Jahresarbeitsentgeltgrenze”). 

     

    Freelancers/self-employed

    Independent of an income private health insurance is always open to self-employed, freelancers and civil servants. It is also always possible to set up a private supplementary health insurance in addition to public insurance if the switch to private health insurance is not possible. This is addon coverage is offered for outpatient or inpatient as well as for dental treatments. The benefits of the statutory health insurance can be combined with additional benefits of supplementary in order to reach a coverage level equal (or almost equal) to the level of private health insurance.

    Health Insurance benefits

    What are the benefits of a private health insurance in terms of coverage?

      Common coverage options for private insurance

      A private health insurance enables insured persons to choose their doctor or hospital freely. Another big advantage of private health insurance is the higher level of benefits. The biggest difference to statutory health insurance is seen when comparing coverage for dental treatment and dentures. Without supplementary dental insurance, large co-payments are possible when covered through public (statutory) health insurance. 

      In addition, private health insurance companies usually also reimburse alternative medical treatments for which the statutory health insurance companies will usually not pay. Privately insured patients can benefit from accommodations in single or double rooms and a chief physician treatment for inpatient treatments in the hospital. Plus, insured persons can choose the scope of services based on their individual needs. Private health insurance can also offer some advantages in terms of costs. Especially young and healthy policyholders can save a significant amount of money when opting for an affordable plan. The premium for private health insurance can also be further decreased by agreeing on to an annual deductible. Public insurance does not offer the option to include a deductible.

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      What does the cost for private insurance depend on?

        Premium calculation

        In contrast to the statutory health insurance, the premium of private health insurance does not depend on the amount of income. The calculation of the premium is based on the age when entering into the contract (no annual increases based on age!), the state of health and existing medical conditions. Of course, the benefits also play an important role in terms of cost.

        Most private health insurance companies offer different tariffs or enable customers to put together their desired service individually in the form of a modular principle. For certain professional groups such as doctors, civil servants, and dentists, insurers often offer tariffs at, particularly favorable conditions. 

        What are the key advantages of private insurance over public insurance?

          Public insurance benefits: subject to change.

          While the statutory health insurance offers a set service catalog based on government regulations (subject to constant change), the benefits in private health insurance are agreed upon permanently and can not be changed by the insurer. This means privately insured patients can benefit from the latest and best forms of treatment which aren't always available in public insurance. In particuliar the very cost intensive forms of treamtents for severe conditions, such as cancer, are frequently not covered under public insurance while private insurance will cover these treatments. 

          Since the benefits of the various health insurance companies differ significantly, it is of great importance to exactly understand what is and isn't covered under a certain plan.  In order to make sure premiums remain stable long-term it is crucial to choose a trustworthy insurance company. Some providers have been able to offer stable premiums over a very long timeframe while others had to significantly increase premiums. Long-term rate stability is possible but only if the insurance company is carefully selected. Ideally with the help of an English speaking expert.